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<br /> S.1.PriebelM�P�7 � � •
<br /> V!.D.Form J v
<br /> CITY OF EVERETT--�}Vater Dept.
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<br /> ApplicationNo........................ Datg..;'...................---........ ... .-• -
<br /> Install.......�f��.•�••��� ••�•inch water service pipe
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<br /> Lot.....................�v................................. Block No.......�.��................
<br /> Addition ......... /J � � .......
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<br /> \ `� . LABOR AND MATERIAL IISED
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<br /> _No._ Stze _I
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<br /> .,,,�/,'/.....I Lead Connection Complete
<br /> ........1........._.........��...k..�-_.....I Saddlcn Complete
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<br /> 3 ., Service Coc
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<br /> service sox �1- • .
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<br /> No. Hours Labor..................................../,ri..:.Co ��:.�7..�...................__.............
<br /> Cutin....................Pavement....................X........................ ........................Sq.Ft.
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<br /> L�...��, ....X........................ ,.
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<br /> � Yi, J� , L.J° ....................X.__................... ........................
<br /> ' Total ........................Sq.Ft.
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<br /> Rema rks....................................................................... .
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<br /> OrderP.cceived.............................................................................................. /,
<br /> \Vork Completed......................._.................._............. ...............Foreman... �
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